• Francesca Reali, Giuseppe Francesco Sferrazza Papa, Paolo Carlucci, Paola Fracasso, Fabiano Di Marco, Marzia Mandelli, Simone Soldi, Enrica Riva, and Stefano Centanni.
• Respiratory Unit, Dipartimento Scienze della Salute, Università degli Studi di Milano, Milan, Italy.
• Respiration. 2014 Jan 1;88(2):112-5.

BackgroundLung ultrasound is a non-radiating accurate alternative tool to chest X-ray (CXR) in the diagnosis of community-acquired pneumonia (CAP) in adults.ObjectivesThe aim of our study was to define the accuracy of ultrasound in the diagnosis of CAP in children.Methods107 consecutive children with suspected CAP underwent clinical examination, blood sample analysis, CXR and lung ultrasound on admission to the Pediatric Department of the San Paolo Hospital. The diagnosis of pneumonia was made by an independent committee of physicians on the basis of the overall clinical and CXR data.ResultsThe diagnosis of CAP was confirmed by the committee in 81 patients (76%). Ultrasound and CXR were performed in all patients. Ultrasound had a sensitivity of 94% and specificity of 96%, while CXR showed a sensitivity of 82% and a specificity of 94%. In patients with CAP, ultrasound revealed subpleural consolidations with air bronchogram in 70 cases and focal B-lines in 6. A parapneumonic pleural effusion was detected in 17 patients by ultrasound, while only 11 of them could be detected by CXR.ConclusionsIn our series, lung ultrasound was highly accurate for the diagnosis of CAP in hospitalized children. These results provide the rationale for a multicenter study in children.

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